340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN HASTINGS CO.
DSH320005 SAN JUAN REGIONAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
SAN JUAN REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH320005
Entity Address
801 W. MAPLE
FARMINGTON, NM 87401
Medicare Provider Number
320005
Participating Start Date
9/1/2008
Last Recertification Date
8/18/2024
Pharmacy Details
Pharmacy Name
WALGREEN HASTINGS CO.
Pharmacy Address
DBA: WALGREENS # 04510
4221 E. MAIN
FARMINGTON, NM 87402
Pharmacy Comments
Contract Details
Approval Date
10/13/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen S. Miller, CFO
(505) 609-6114
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/13/2015
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session